A comprehensive clinical examination is the basis for selecting further diagnostic steps:
- General physical examination – including blood pressure, pulse, body weight, height; further:
- Inspection (viewing).
- Skin, mucous membranes, oral cavity, and sclera (white part of the eye) [accompanying symptoms: sialadenosis (salivary gland enlargement); scars on the back of the hand from repeated bite wounds; enamel recession; peripheral edema (water retention in tissues)] [due topossible sequelae: dental damage to the point of falling out of the teeth].
- Abdomen (abdomen)
- Shape of the abdomen?
- Skin color? Skin texture?
- Efflorescences (skin changes)?
- Pulsations? Bowel movements?
- Visible vessels?
- Scars? Hernias (fractures)?
- Inspection and palpation of the neck [due topossible sequelae: Hypertrophy (enlargement) of the parotid (parotid glands) and submandibular glands]
- Auscultation (listening) of the heart [due tosymptom (rare) or possible sequelae: cardiac arrhythmias].
- Auscultation of the lungs
- Palpation (palpation) of the abdomen (stomach), etc. with an attempt to palpate the liver (pressure pain?, knocking pain?, coughing pain?, defensive tension?, hernial ports?, kidney bearing knocking pain?) [due todifferential diagnoses: hepatitis (liver inflammation), functional gastrointestinal disorders, gastritis (gastritis)].
- Digital rectal examination (DRU) including inspection: examination of the rectum (rectum) [due todifferential diagnoses: chronic inflammatory bowel disease such as ulcerative colitis or Crohn’s disease].
- Inspection (viewing).
- If necessary, gynecological examination [due topossible symptoms (rare): oligomenorrhea (the interval between bleeding is > 35 days and ≤ 90 days, ie, too infrequent menstruation), amenorrhea (absence of menstruation)]
- Psychiatric examination[due topossible cause: depression] [due todifferential diagnoses:
- Acute adjustment disorder
- Alcohol abuse (heavy drinking; alcohol abuse).
- Anxiety disorders
- Anorexia nervosa (Anorexia)
- Depression
- Substance abuse
- Personality disorders
- Schizophrenia (severe mental illness belonging to the endogenous psychoses and characterized by disturbances of thinking, perception and affectivity).
- Nonspecific eating disorders
- Obsessive-compulsive disorder]
[due topossible sequelae:
- Other addictive diseases
- Anxiety disorders
- Anorexia nervosa (Anorexia)
- Depression
- Impulse control disorders
- Personality disorders
- Recurrence (recurrence) of bulimia nervosa
- Obsessive-compulsive disorder]
- Health Check
Square brackets [ ] indicate possible pathological (pathological) physical findings.